Five Year Survey of Toxicological Testing of Clinical Body Fluid Samples at the Poison Control Centre in the Indian State of Kerala

The Poison Control Centre (PCC) at Amrita Institute of Medical Sciences, Kerala, was established in June 2003, but became fully operational from January 2005.There are only four PCCs in India recognized by the World Health Organization, of which this is one.A five-year (2005 to 2009) review of biological samples analyzed for chemicals, drugs and toxins by the analytical laboratory attached to the PCC is presented to give an indication of the commonest types of poisoning encountered in this region of India, aside from venomous bites and stings.Such data are not adequately available so far, which is also true for other parts of the country.Results of the survey show that there has been a steady rise in the receipt of samples over the entire period from 432 in 2005 to 601 in 2009.Among the samples analyzed, the commonest toxicants are pesticides, pharmaceuticals, heavy metals and alcohols.Of the pesticides, organophosphates accounted for the maximum number, while most of the remaining comprised zinc phosphide, carbamates, pyrethroids, paraquat, phosphorus, and bromadiolone.Aluminium phosphide, which is a common pesticide in some other regions, was virtually non-existent, while zinc phosphide, a rodenticide, is the second highest in incidence.Of the pharmaceuticals, the largest number comprised sedativehypnotics, while antipyretic drugs, especially paracetamol, accounted for a most of the remaining.Of the metals, the commonest was lead, followed by arsenic, mercury, iron, etc. Requests for copper testing were common, but mostly pertained to Wilson"s disease, and not toxicity.Among the alcohols, ethanol was the commonest.Even though Kerala is rich in flora, plant toxins were low in incidence, because of the difficulty in testing for such toxins, as compared to chemicals.Bites and stings were not included in this study.Therapeutic monitoring of drugs, which accounts for a large number of samples received by the laboratory was also not part of the survey.